PIAKUIKKA. 227 



:iinl typhoi<l fever, and is too frequently an accompaniment of th - 

 i>f consumption. It often prove-, tin- immediate cause of death in people 

 iia\e been Ion;; routined to l>ed by chronic illness. 



hiarrhu-a, however, is not unfrecjuently the sole. or at all events the essential, 

 cause of complaint. It is the disease itself, and not a mere symptom of some other 

 malady. 



The causes of diarrhoea are numerous, one of the most common being some error 



in diet, It may be the result of over-rating and drinking, or of taking some 



ular article of food which has disagreed with the stomach and set up 



irritation. People after a lai'L'e dinner not uncommonly suffer from (liarrlui-a. It 



tally attributed to the salmon or oyster-sauce, or to some perfectly innocent 



article, \vhereas in reality it is due to the mixture of the various kinds of food and 



drink, and more esjMvially to the actual quantity taken. The stomach and bowels 



not unnaturally rebel when made the receptacle of such a heterogeneous collection of 



substances. There are certain articles of diet, however, which undoubtedly have ; 



strong tendency to provoke diarrhoea; and amongst these comparatively indigestible 



we may enumerate unripe fruit, raw vegetables, sausages, pork, veal, 



. duck, c. Many kinds of shell-fish, such as lobsters, crabs, and mussel -. 



apt to act as irritants. Putrid food, or, to use the more refined phraseology of 



gastronomers, food which is high, has the same effect on many people, who would 



'{uently do well to take their venison and game with a certain amount of 



caution. Articles of diet which are in themselves perfectly good and wholesome 



often cause diarrhn-a when resorted to for the first time. This is, in all probability, 



the explanation of the free purging from which many of us suffer on our first visit 



to the Continent. Bad cooking may lead to diarrhoea, and has sometimes caused quite 



an epidemic in large establishments. 



Impure water is another common cause. Water contaminated with decomposing 

 animal matter, or with sewage or sewage gas, is pretty certain to cause diarrhoea, 

 either at once or gradually, according to the degree of impurity and the quantities in 

 which it is consumed. Symptoms resembling those of cholera are sometimes pro- 

 duced by drinking the waters of the Volga, which are impregnated with sewage. In 

 St Petersburg, the water of the Neva, which is rich in organic substances, gives 

 diarrhoea to strangers. When diarrhoea prevails over a limited area, as in only a 

 certain row of houses, the condition of the water supply should always be investigated. 



T>ad smells often give rise to diarrhoea. Many people who live in the neigh- 

 bourhood of grave yards suffer in this way. The smell from a newly-opened cesspool, 

 or the emanations from a manure "heap, or, worse still, a manure manufactory, have 

 been known to have the same effect. Medical students when first they commence 

 dissecting, or at later periods of their career, if they apply too assiduously, are often 

 sufferers. 



Worms are not unfrequently the cause of looseness of the bowels, not only in 

 children, but also in adults. The round worm, as a rule, causes more irritation 

 than the tape-worm. 



Mental emotions, more especially fear and anxiety, sometimes act as an 

 exciting cause. The anticipation of any unusual ordeal, such as speaking in public, 



